Minced and moist food IDDSI Level 5

IDDSI is the International Dysphagia Diet Standardisation Initiative.

Why is this food texture needed?

It can be recommended for people who may have difficulties biting off pieces of food, chewing and swallowing but have some basic or beginner chewing ability. Some people may be able to bite off a large piece of food but may not be able to chew it down into little pieces that are safe to swallow. You only need a small amount of chewing to break down this texture for safe swallowing. It is important that Minced & Moist foods are not too sticky because this can cause the food to stick to the cheeks, teeth, roof of the mouth or in the throat.

What is minced & moist food?

• It is soft and moist but with no liquid leaking or dripping from the food.
• Food has been mashed or minced before serving.
• Biting is not required.
• It has lumps 4mm in size which is about the gap between the prongs of a fork.
• Lumps can be mashed with the tongue. It needs minimal chewing.
• Food can be easily mashed with just a little pressure from a fork.
• Holds its shape on a spoon but falls easily if the spoon is tilted or lightly flicked.

These aren't appropriate

• Lumps should not be firm.
• It does not need biting.
• No mixed (thick - thin) textures for example cereal in milk, mince in gravy, and dried fruit in sponge.

Food examples

Meat / fish

• Must be finely minced or chopped to 4mm lump size for adults.
• Serve in a thick, smooth, non-pouring sauce or gravy.
• If it cannot be finely minced, it should be puréed.

Fruit

• Serve finely mashed or use a blender to finely chop it to 4mm lump size pieces.
• Drain any excess liquid that has separated.

Vegetables

• Must be cooked.
• Must be finely mashed or use a blender to finely chop it to 4mm lump size pieces.
• Drain any excess liquid that has separated.

Cereal

• Served thick with small soft 4mm lumps.
• Any milk/ fluid should not separate from the cereal.
• Drain any excess liquid before serving.

Rice

• Requires a sauce to moisten it and hold it together.
• Rice should not be sticky or gluey and should not separate into individual grains when cooked and served.
• May require a thick, smooth, non-pouring sauce to moisten and hold the rice together

Dessert

• The texture of very thick, smooth yoghurt or stewed apple in very thick custard. Any lumps must be up to 4mm in size.
• Or the texture of soft sponge cake with smooth filling, fully softened by mashing and mixing in with very thick, smooth custard.
• No ice-cream or jelly if a person requires thickened fluids (because these can change to thin fluid in the mouth).

No regular dry bread due to high choking risk.

Meal ideas

Foods to avoid

Mixed thin and thick textures to avoid

Soup with pieces of food, cereal with milk

Hard or dry foods to avoid

Nuts, raw vegetables (e.g. carrot, cauliflower, broccoli), dry cakes, bread, dry cereal

Tough or fibrous foods to avoid

Steak, pineapple

Chewy or sticky foods to avoid

Lollies / candies / sweets, cheese chunks, marshmallows, chewing gum, sticky mashed potato, dried fruits, sticky foods

Crispy foods to avoid

Crackling, crisp bacon, cornflakes

Crunchy foods to avoid

Raw carrot, raw apple, popcorn

Sharp or spiky foods to avoid

Corn chips and crisps

Crumbly bits to avoid

Dry cake crumble, dry biscuits

Pips and seeds to avoid

Apple seeds, pumpkin seeds, white of an orange

Food with skins or outer shell to avoid

Peas, grapes, chicken skin, salmon skin, sausage skin

Foods with husks to avoid

Corn, shredded wheat, bran

Bone or gristle to avoid

Chicken bones, fish bones, other bones, meat with gristle

Round, long shaped foods to avoid

Sausage, grape

Sticky or gummy foods to avoid

Nut butter; overcooked oatmeal / porridge, edible gelatin, sticky rice cakes

Stringy foods to avoid

Beans, rhubarb

Crust formed during cooking to avoid

Crust or skin that forms on food during cooking or after heating, for example, cheese topping, mashed potato

‘Floppy’ foods to avoid

Lettuce, cucumber, baby spinach leaves

‘Juicy’ foods to avoid

Where juice separates from the food piece in the mouth; for example, watermelon

Large or hard lumps to avoid

Casserole pieces larger than 4mmx4mm; fruit, vegetable, meat or other food pieces larger than 4mmx4mm.

Useful resources

• The Caroline Walker Trust (opens in a new tab) for information and guidance to encourage eating well.
• Wiltshire Farm Foods (opens in a new tab)for ready prepared, frozen Minced & Moist texture meals that can be delivered to your home
• It’s made for you for ready prepared frozen Minced & Moist texture meals that can be delivered to your home.

If you have any questions please speak to your speech and language therapist directly or contact the Speech and Language Therapy Department on 01223 216200.

References / sources of evidence

© The International Dysphagia Diet Standardisation Initiative 2019 @ The IDDSI framework (opens in a new tab). Licensed under the Creative Commons Attribution-ShareAlike 4.0 License.